51167.2 Plumbing Permitf"'"'I) .. LOT NO. /0
NO. EET �
APPLICATION FOR PLUMBING PERMIT
CITY OF CUPERTINO
��'�-��7 m� Sanitary No.
1) t_:✓n �J 1968 Permit No �'�-
`6
'Pin -n 1968 J
Fee
Application is hereby made -to the City of Cupertino for a permit to install plumbing
Pi
pes and/or fixtures listed on the reverse side hereof, and agrees to install said prices
ands)/orifixtures imaccordancc,with the provisions of the Plumbing Code of the City of
Cupertino,=and all�otherliaws aj;j licable thereto.
Use of Premises Ihrelling
Owner Ditz Crane Company
By. Palm Plumbing Company
CONTRACTOR,AGENT
245-2323
State License 186579
RJ�5 De La Cruz Boulevard
rress
M,s5t*vale-Saratoga Road
Approved
PLUMBING INSPECTOR
FIXTURES
NUMBER
MAIN DRAIN
UNITS FEES
UNITS FEES
Waier Heater
WATER SYSTEM
Size
Water Closet
Material
Bath Tub
/
To Curb
Shower
/
To Prop. Line k-�
Lavatories
Main Drain Fee
To Existing
Kitchen Sink
/
Not Conn.
Dish Washer
Sewer Box
Waste Disposal
Wash Tray
STORM DRAINAGE
Comb.Sink & Tray
To Curb
Dental Unit
Drinking Fountain
Floor Drain
WATER SYSTEM
Hopper
Size
Restaurant Sink
Material
Sand Trap
TOTAL FEES
Urinal
Fixture Fee
Area Drain
Main Drain Fee
Water Leader
Storm Drain Fee
Sprinkler Valve
Water Svs. Fee I
Filter
Total I // 1/j 5J 11 Total Fee 1 .26512_1